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Utilization Review Lead

Company: LogistiCare
Location: Southfield
Posted on: June 14, 2018

Job Description:

The Utilization Review Lead is responsible for reviewing non-emergency medical transportation requests for stretcher, ambulance and wheelchair transport and works with LogistiCare staff to assist in quality assurance of these trips. ESSENTIAL FUNCTIONS Assist in the review all ambulance and stretcher trips to assure appropriate utilization of resources Assist with screening all medical documentation and make decisions based on provided information to determine the most efficient and appropriate method of transport or most appropriate medical provider Assists with standing order recertification Audits whether provider billed for previously cancelled trips and/or was paid for trips that did not occur Maintain client confidentiality by compliance to HIPPA guidelines and LogistiCare confidentiality policy Act as a resource for LogistiCare staff for all medical questions Provide superior customer service to clients performing the above mentioned job duties and responsibilities Responsible for supervision of Utilization Review staff, while maximizing the potential of each employee supervised Performs other duties and responsibilities as assigned POSITION QUALIFICATIONS Competency Statement(s) Accurate - Ability to perform work accurately and thoroughly Communication, Oral - Ability to communicate effectively with others using the spoken word Communication, Written - Ability to communicate in writing clearly and concisely Customer Oriented - Ability to take care of the customers' needs while following company procedures Interpersonal - Ability to get along well with a variety of personalities and individuals Patience - Ability to act calmly under stress and strain, and of not being hasty or impetuous Reliability - The trait of being dependable and trustworthy REQUIREMENTS Education High School Graduate or General Education Degree (GED) Experience At least two years prior experience in a fast-paced, high level customer service oriented environment strongly preferred 1+ years demonstrated experience in a lead position preferred Social Services and/or case management, basic medical terminology and/or front or back office medical experience preferred SKILLS & ABILITIES Excellent customer service and phone skills Must be able to work independently and as a part of a team Ability to foster and maintain a positive environment Ability to quickly learn new technology Must be able to understand and follow complex instructions Ability to accurately type 35wpm Read and write English fluently Proficient in Microsoft Word, Excel and Outlook and must be able to learn and acquire proficiency in LogistiCare's proprietary software application (s) Bi-lingual a plus PHYSICAL DEMANDS The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee is regularly required to talk or hear. The employee is frequently required to use hands to finger, handle, or feel. The employee is occasionally required to stand, walk, reach with hands and arms. Specific vision abilities required by this job include close vision. SUPERVISORY RESPONSIBILITIES Assists the Utilization Review Manager and Supervisor by monitoring the performance of the Utilization Review Specialist. Carries out lead responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include assisting and assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Entire work time is conducted in an office environment in a controlled atmosphere building. The noise level in the work environment is usually moderate. LogistiCare is an Equal Opportunity Employer. Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Keywords: LogistiCare, Southfield, Utilization Review Lead, Other, Southfield, Michigan

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